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APPLICATION FOR LIANA PROFESSIONAL REGISTRATION1. PERSONAL DETAILS Your name as entered here will appear on any certificates awarded by LIANA and the Registration Roll. First Name/ Ingot Preferred
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My name as entered is John Smith.
The individual named John Smith is required to file.
You can fill out my name as entered by using the exact spelling 'John Smith'.
The purpose of my name as entered is to uniquely identify me.
The information that must be reported on my name as entered includes my full name and any associated identifiers.
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